What is cardia achalasia? Cardia achalasia is a rare esophageal motility disorder characterized by reduced esophageal peristalsis, hypertension of the lower esophageal sphincter and a weakened relaxation response to swallowing movements. The main clinical manifestations are dysphagia, retrosternal pain, food reflux, and respiratory infections due to aspiration. The main goal of the current treatment for cardia inactivation is to reduce the pressure at the esophagogastric junction to allow the smooth passage of food. POEM surgery In 2010, Japanese experts such as Inoue first proposed transoral endoscopic myotomy (POEM) for the treatment of achalasia of the cardia, which was then gradually promoted worldwide.POEM surgery is a transnatural lumen endoscopic procedure. Compared with surgery, POEM surgery without body incision has the advantages of less trauma and faster recovery. POEM surgery steps 1, about 10cm above the gastroesophageal junction submucosal injection 2, incision of the mucosal layer about 1.5-2cm to reveal the submucosal layer 3, separation of the submucosal layer, the establishment of submucosal “tunnel” until 2-3cm below the gastroesophageal junction 4, from the “tunnel 4. Starting from 2cm below the entrance of the “tunnel”, the muscle bundle was incised longitudinally from top to bottom and from superficial to deep to more than 2cm below the gastroesophageal junction 5. Metal clips were used to close the incision of the mucosal layer